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Tag Archive for: occupational therapy

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OT or PT? Both or Neither?

Guest Blogger: Carolyn Rocca, Student Occupational Therapist

The differences and similarities between Occupational Therapy and Physiotherapy have long been confused. This makes sense, especially since both professions ultimately started as “POT”, meaning people studied to be a Physical and Occupational Therapist and worked in a dual role, providing both. However, since the mid-1970’s the roles have been separated and yet people still confuse the two. I am still often asked “oh, so you are like a physiotherapist”…followed typically by a question about some ailing body part.

Although both Occupational Therapy (OT) and Physiotherapy (PT) are registered healthcare professions specifically in the domain of rehabilitation, each profession has it’s unique role and purpose in one’s recovery following injury or illness, as well as in the prevention of disease, further injury, and disability.

There is no single way to define or categorize each profession. However, the Canadian Association of Occupational Therapists (CAOT) describes OT as the art and science of enabling engagement in everyday living by empowering people to participate to their potential in the daily occupations that foster health and well-being (Townsend & Polatajko, 2013, p. 380). In the OT profession, the term occupation is considered everything that people do throughout the course of their lives that is considered essential to their health and well-being (i.e. how people “occupy” their time). For example, an occupation can range from one’s ability to shower and groom themselves, to their ability to carry out their role as a parent, spouse, or employee.

Therefore, OTs are trained to assess and help clients identify areas in their lives that have been impacted following injury or illness, such as their ability to care for themselves, care for their families, manage their households, perform at work or school, and participate in volunteer or leisure activities. An OT would then assist their clients in building goals around those areas that are important to them, and to then provide recommendations, strategies, assistive devices, and education in order to find solutions to these day to day challenges.

Whereas, the Canadian Physiotherapy Association (CPA) describes PT as a client-focused health profession dedicated to improving quality of life by: promoting optimal mobility, physical activity, and overall health and wellness, and improving and maintaining optimal functional independence and physical performance (CPA, 2012). Therefore, PTs are experts in human anatomy and the functioning of the many systems within our bodies.

Their role involves conducting detailed and holistic assessments of their clients’ movement, mobility, and functioning, creating rehabilitation goals for recovery with their clients, followed by developing personalized intervention plans. PT intervention can include education, individualized therapeutic exercise geared towards increasing strength and range of motion, manual therapy techniques such as massage and manipulation, the use of modalities including ultrasound and electrical stimulation, and the prescription of assistive equipment.

While both professions consider the physical, social, psychological and emotional well-being of their clients, one primary difference between the professions is that PTs are trained to recognize when there is a need for specialized mental health treatment, and subsequently refer their client to an appropriate healthcare provider, whereas OTs are trained to assess and provide treatment for mental health conditions. This treatment can consist of teaching and practicing coping strategies by providing counselling and psychoeducation. Further, while a PT may recognize and understand how someone being unable to walk impacts work and home, the OT will help people to “manage in the meantime”.  So, while you are building your strength and endurance on that broken leg through physio, your OT will help you to manage other important tasks in a modified fashion when at home, work, school or in the community.

Nevertheless, perhaps the largest difference between the professions is that a PT tends to treat the client’s actual impairment, while an OT tends to help the client complete everyday tasks with the impairment. For example, consider a client who has undergone surgery for a hip replacement. Throughout their recovery, a PT might prescribe an individualized at home exercise program to gradually stretch and strengthen the hip in order to prevent deconditioning and to rebuild the muscles needed for walking. A PT will also be vital in terms of educating them on the proper use of crutches in order to safely move around their environment. Meanwhile, an OT will be an essential part of this client’s recovery as they likely require specialized bath equipment for safe showering, adaptive devices for putting on socks and shoes, and education in terms of strategies to transfer safely into and out of their car. Essentially the OT would focus on getting the client back to their day to day tasks and life roles despite the limitations presented by their impairment.

All in all, even with their unique roles, the OT and PT professions do have similarities. Both OTs and PTs can be accessed in hospitals, community care, private practice, rehabilitation centres, family health teams, long term care centres, and school health. Additionally, both professions are client-centred, meaning they focus on what is important to the client, and on maximizing their independence, safety, and function. Neither require a referral, so people can ask for, and receive these therapies without a referral. Despite these similarities, their above highlighted differences allow each profession to offer distinct roles, meaning PT or OT, both or neither may be most appropriate for you. Overall, both OTs and PTs are vital members of healthcare teams and together they offer many needed services throughout the rehabilitation process.

 

Resources & References

Canadian Association of Occupational Therapists (CAOT) website: http://www.caot.ca/default_home.asp?pageid=2412

Canadian Physiotherapy Association (CPA) website: https://physiotherapy.ca/

Canadian Physiotherapy Association (CPA) (2012). Description of physiotherapy in Canada. Retrieved from https://physiotherapy.ca/sites/default/files/site_documents/dopen-en.pdf

Townsend, E. A., & Polatajko, H. J. (2013). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation. Ottawa, ON: CAOT Publications ACE.

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Aquatic Therapy: Is it Right for you?

Guest Blogger: Carolyn Rocca, Student Occupational Therapist

Water has long been associated with health and healing, making it an excellent tool for rehabilitation. Aquatic therapy, also referred to as pool therapy or hydrotherapy, is one way in which water can be used for therapeutic purposes following injury or illness.

Aquatic therapy refers to water-based treatments or exercises aimed to enable physical rehabilitation, fitness, and relaxation for therapeutic purposes. Treatments and exercises are performed while floating, partially submerged, or fully submerged in water, usually in specialized temperature-controlled pools. The key difference between this form of therapy and land therapy is that movement is facilitated by the physical properties of water, particularly it’s density and specific gravity, hydrostatic pressure, buoyancy, viscosity, and thermodynamics (Becker, 2009).

Due to the specific facilitating properties of water, aquatic therapy can have several benefits for people who have loss or restriction of joint motion, strength, mobility, or function as a result of a specific disease or injury. Aquatic therapies are beneficial in the management of musculoskeletal issues, neurological conditions, and cardiopulmonary problems. More specifically, there is evidence to support that people with fibromyalgia, arthritis, multiple sclerosis, cerebral palsy, stroke, and chronic pain, as well as people who have undergone surgeries such as total knee and total hip replacements, can significantly benefit from aquatic therapy (CARI, 2014).

The benefits of hydrotherapy will depend on the purpose of why it is being used in your rehabilitation plan, what it is aiming to target, and the type of exercise being completed in the water. In general, there is evidence to support that within a wide range of ages and abilities, hydrotherapy may help people to increase their endurance and strength, improve balance and postural control, reduce perceived pain and muscle spasms, reduce joint pain and stiffness, aid in gait retraining, and improve functional mobility. Additional benefits can include the facilitation of relaxation, improved quality of life, as well as providing opportunities for socialization (CARI, 2014).

A key to the success of many aquatic therapy procedures is the constant attendance and guidance provided by a trained therapist. This can be any rehabilitation professional, such as a physical therapist, occupational therapist, PTA/OTA, etc., who has taken additional and specific training in basic or advanced aquatic physical therapy. The rehab professional’s expertise will be able to match your abilities with the appropriate properties of water to achieve an optimum balance between facilitation and challenge. By adjusting the immersion temperature, type and intensity of activity, level of resistance, use of equipment, and treatment duration the therapist will be able to assist your recovery by gradually increasing the amount of challenge to eventually help you to transition to land exercises.

An added bonus to the therapeutic benefits of aquatic therapy is that it can help to introduce or re-connect you to a leisure interest, and can offer a social outlet. For example, a current client of mine has recently begun pool therapy following injuries sustained in a motor-vehicle collision. Not only will this help in her recovery while she begins to regain strength and function in her legs, but will also re-connect her to her passion for swimming, as this was something she loved to do with friends prior to her accident. Additionally, there is evidence to support that infants and toddlers with mobility impairments that engaged in aquatic therapy can experience significant functional gains in mobility compared to children who solely received land therapy, and that their parents noticed an increase in their socialization and enjoyment while in the pool. In this particular study, the children’s parents then reported an increased willingness and comfort in bringing their children to community pools following aquatic therapy (McManus, & Kotelchuck, 2007), therefore further increasing their future leisure and social opportunities.

Thus, aquatic therapy has the potential to improve physical function, as well as increase community involvement, socialization opportunities, and participation in physical activities. Additionally, this form of therapy can be appropriate and beneficial for all ages and abilities. If you feel that aquatic therapy may be a great addition to your rehabilitation and recovery, speak to your rehabilitation professional about some of the opportunities available in your community.

 

References & Resources

Becker, B. E. (2009). Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM&R, 1(9), 859-872.

Canadian Aquatic Rehab Instructors (CARI) website: http://www.aquaticrehab.ca/

Canadian Aquatic Rehab Instructors (CARI) website link to research (2014). Retrieved from http://www.aquaticrehab.ca/research

McManus, B. M., & Kotelchuck, M. (2007). The effect of aquatic therapy on functional mobility of infants and toddlers in early intervention. Pediatric Physical Therapy, 19(4), 275-282.

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Struggling with Sleep? Try This Helpful Tool

Proper sleep is vital to our mental and physical health, and lack of sleep can negatively affect productivity and function.  If you suffer from poor sleep, know that you are not alone.  Statistics Canada estimates that approximately 3.5 million Canadians struggle with sleep.  There are many ways to get help and in all of these, tracking your sleep is an important tool.  Use our free printable Two-Part Weekly Sleep Diary to help you track and identify what helps and what hinders your sleep habits.  Simply print and fill in your diaries before bed each night and when you wake up each morning.

Also check out our video Improving Sleep to learn some solutions from Occupational Therapists that can help.

For more helpful tools and checklists please visit our Printable Resources page.

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Living with Cancer and the Role of OT

Cancer and cancer treatment can lead to changes in how we do our daily activities due to physical, cognitive or emotional changes resulting from the diagnosis, resulting surgery, medications, chemo and radiation. For a cancer patient sometimes just doing daily activities leaves little energy for leisure, social, or work-related tasks.  Common side effects of cancer or its treatment include fatigue, pain, weakness, cognitive difficulties, anxiety or depression, and changes in self-esteem or self-image. Each person diagnosed with cancer will experience different challenges in his or her participation in various daily activities and life roles over the course of the disease.

Occupational therapists have knowledge and expertise to allow individuals with cancer to do the things they want and need to do to maintain their level of independence and quality of life. Occupational therapy services are helpful for individuals throughout the continuum of cancer care, including those who are newly diagnosed, undergoing treatment, receiving hospice or palliative care, or who are survivors reintegrating into previous roles. Caregivers also benefit from the training and education provided by OT’s as this arms them with the essential tools to offer support and assistance to their loved ones when performing daily, important, and meaningful activities.

Take a look at the following infographic to learn more about how Occupational Therapists can help:

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The Role of Occupational Therapy in Trauma Recovery

Guest Blogger: Carolyn Rocca, Student Occupational Therapist, 2017

Motor vehicle accidents account for countless injuries annually and are one of the most common traumas individuals experience. Trauma can be understood as one’s unique experience of an extremely stressful event or enduring conditions that overwhelms their ability to cope. These experiences can often disconnect us from our sense of safety, resourcefulness, and coping. As a result, survivors of severe and traumatic motor vehicle accidents are at increased risk for experiencing mental health difficulties, with posttraumatic stress disorder, depression, and anxiety being the most common.

Post-traumatic stress disorder (PTSD) is a mental health condition that can follow a traumatic event involving actual or threatened death, serious injury, or threat to the physical integrity of oneself or others. Although every individual experiences PTSD differently, following a motor vehicle accident PTSD symptoms can involve:

·       Psychologically re-experiencing the trauma through distressing thoughts or dreams about the accident,

·       Avoidance of thoughts or situations associated with the accident, including a reluctance to return to driving,

·       Extremes in emotional responsiveness, by either having greatly reduced or heightened emotions, and

·       Increased physical arousal, such as hypervigilance, exaggerated startle, irritability, and disturbed sleep (Beck & Coffey, 2007).

The symptoms associated with PTSD can leave individuals to feel emotionally, cognitively, and physically overwhelmed. Naturally, this can result in difficulties in one’s daily functioning, including one’s ability to care for themselves and others, as well as their ability to successfully engage in their life roles of being a spouse, parent, employee, student, or volunteer, to name a few. For these reasons it is recommended that those experiencing PTSD seek help from a team of healthcare providers and consider occupational therapy.

Using a trauma-informed care approach, occupational therapists can support clients through the following three Phases of Trauma Recovery:

Phase I – Safety-stabilization:

Since trauma often results in a sense of helplessness, isolation, and loss of control, the aim is to restore a sense of safety and empowerment. Following trauma, creating a sense of safety is the foundation of one’s recovery process.

The first step to building and creating safety is to first identify things that help us feel safer. Occupational therapists can help their clients to identify objects that bring about a personal sense of safety and imbed them into their daily routines. These safety objects may include: special people such as a trusted friend, engaging in certain activities like looking at photographs or making crafts, or being in a certain place, such as being outdoors in the sunlight.

Occupational therapists can also assist in establishing safety through practices such as meditation, mindfulness, deep breathing exercises, yoga, and Thai chi, as these approaches have been shown to be effective at decreasing stress and soothing the nervous system (Manitoba Trauma Information & Education Centre, 2013).

Phase 2 – Remembrance and Mourning:

A traumatic event like a motor vehicle accident is often associated with a form of loss. One might feel they have lost their independence, sense of identity, or purpose following a car accident.

Counselors and occupational therapists are well-equipped to guide individuals on their recovery by allowing them time to grieve and morn their own personal losses. This is often achieved through individual or group-based therapy by processing the trauma, putting words and emotions to it, and making meaning of it.

Phase 3 – Reintegration:

The goal of the third stage of recovery is that the person affected by trauma recognizes the impact of their experience but is now ready to take concrete steps towards a lifestyle that is no longer controlled by the trauma. Recovery and reintegration will look different for everyone, but often involves resuming important life roles and responsibilities, and returning to a lifestyle that is meaningful to them.

Occupational therapists can assist during this phase of recovery by supporting their clients in re-establishing healthy routines, building strong support systems, learning and practicing coping strategies during their day to day activities, and gradually increasing their exposure to anxiety provoking triggers, ultimately enabling them to reintegrate into their communities and preferred lifestyles.

For more information about PTSD, trauma informed care, and how healthcare professionals can support someone following trauma, be sure to take a look at the Trauma Toolkit or call an Occupational Therapist to start the process of recovery.

 

References & Resources:

Beck, J. G., & Coffey, S. F. (2007). Assessment and treatment of posttraumatic stress disorder after a motor vehicle collision: Empirical findings and clinical observations. Professional Psychology: Research and Practice, 38(6), 629.

Manitoba Trauma Information & Education Centre (2013). Retrieved from http://trauma-recovery.ca/

The Trauma Toolkit: A resource for service organizations and providers to deliver services that are trauma-informed (2013). Retrieved from http://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf

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OT and Chemo Brain

Chemotherapy is a very common treatment for many types of cancers.  Chemotherapy uses drugs to destroy cancer cells in the body.  When going through chemotherapy many negative side effects often occur, including what is referred to as “chemo fog, “ or “chemo brain.”  This particular side effect refers to problems that can arise with respect to thinking, memory and other cognitive skills.  Occupational Therapy can help!  Learn more about OT’s helpful role in the following article care of the Minn Post.

Minn Post:  Mary Radomski: Occupational therapy can help ease symptoms of ‘chemo brain’

In April the Canadian Cancer Society celebrates Daffodil month.  It as a month to create awareness and raise funds for research and to support those living with cancer.  To support the Canadian Cancer Society please visit their website.

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Autism and the Role of Occupational Therapy

On April 2nd the world “lit it up blue” in support of World Autism Awareness Day.  It is estimated that Autism Spectrum Disorder affects over 3 million individuals in the U.S. and tens of millions worldwide.

Occupational Therapy plays an important role in helping individuals living with autism.  Learn many of the ways an OT can support individuals and their families in the following infographic:

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Solutions for Disability-Related Financial Stress

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

I can say with certainty that 100% of my clients suffer from financial difficulty when faced with disability, trauma or injury.  It is just not common for people to plan for the “rainy day” that could be ill health.  Yet, the impact of financial strain is significant.  Stress, anxiety, panic, excessive worry, loss of sleep, relationship issues, poor decision making, and maladaptive coping are all common reactions to feeling that you are unable to survive a change in income or increased expenses from medication, devices or therapy.

In the following video from our OT-V series, we discuss how an Occupational Therapist uses strategies to help you through financial difficulties and to help manage the negative effects to your health.